住院时间延长的胎粪吸入综合征新生儿临床特征及2岁患病情况分析

Analysis of clinical features and incidence of meconium inhalation syndrome in new⁃borns with prolonged hospital stay at 2 years old

目的:探索新生儿胎粪吸入综合征(meconium aspiration syndrome,MAS)的临床特征及生后2岁内患病情况,为临床疾病管理提供参考。方法:回顾性收集2016年6月至2021年5月收治的87例MAS新生儿的临床资料及调查出院后2岁患病情况,根据住院时长分为>7天组(42例)与≤7天组(45例),比较两组在院病例资料及2岁内患病调查资料。结果:较≤7天组,>7天组住院费用、患儿窒息比例、在院并发气漏比例、高频呼吸机辅助通气及有创呼吸机辅助通气占比、第1天白细胞数、发生血小板减少占比、第7天血小板平均体积更高,初始FiO_(2)、入院1小时FiO_(2)、总氧疗时长与使用抗生素总时长更长,差异显著(P<0.05)。2岁内患病情况比较:>7天组喘息人数高于≤7天组,差异显著(P<0.05)。结论:近一半的胎粪吸入综合征新生儿住院时间延长及住院费用增加。胎粪吸入综合征新生儿住院时间延长与窒息、气漏、有创呼吸机辅助通气、感染有关。住院时间延长的胎粪吸入综合征患儿生后2岁内更容易发生喘息。

Objective:To explore the clinical features of meconium aspiration syndrome(MAS)in newborns and their disease status within 2 years after birth,providing insights for clinical disease management.Methods:A retrospec-tive review was conducted on clinical data of 87 cases of MAS newborns admitted from June 2016 to May 2021 and their disease status at 2 years post-discharge.The cases were divided into>7 days group(42 cases)and≤7 days group(45 cases).A comparison was made between the two groups in terms of in-hospital data and disease status within 2 years.Re-sults:In comparison to the≤7 days group,the>7 days group showed significantly higher hospitalization costs,inci-dence of neonatal asphyxia,air leak during hospitalization,proportion of high-frequency ventilator and invasive ventila-tor assistance,higher white blood cell count on the first day,higher incidence of platelet decrease,higher mean platelet volume on the 7th day,longer initial FiO_(2),admission 1-hour FiO_(2),total oxygen therapy duration,and total antibiotic use duration(P<0.05).Comparison of disease status within 2 years:The>7 days group had a higher number of wheez-ing cases than the≤7 days group,with a significant difference(P<0.05).Conclusion:Nearly half of MAS newborns ex-perienced prolonged hospital stays and increased hospitalization costs.Prolonged hospitalization in MAS newborns is asso-ciated with asphyxia,air leak,invasive ventilator assistance,and infection.MAS infants with extended hospital stays are more prone to wheezing within 2 years postpartum.